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McNall S, Hooper K, Sullivan T, Rieger-Christ K, Clements M. Treatment Modalities for Non-Muscle Invasive Bladder Cancer: An Updated Review. Cancers (Basel) 2024; 16:1843. [PMID: 38791924 PMCID: PMC11120410 DOI: 10.3390/cancers16101843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/01/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
The landscape of treatment for non-muscle invasive bladder cancer is rapidly changing. A complete and careful transurethral resection is the mainstay of initial treatment and is followed by intravesical therapy in intermediate or high-risk cases. The standard of care is intravesical BCG. Many alternative or additive approaches to this are being explored. We divided this review into three relevant spaces to consider these novel treatment approaches: (1) low-risk disease, for which intravesical therapy is not usually considered, (2) BCG-naïve disease (i.e., considering alternatives to the standard therapy), and (3) BCG-unresponsive disease. We performed a review of published literature and summarized ongoing trials in the United States. Novel approaches that we explored include surgical techniques for resection, alterations in dwell time for intravesical therapy, delivery method and schedule of intravesical therapies, new intravesical therapy agents, and systemic therapies (especially immunotherapy). These are thoroughly outlined throughout this review article, and the numerous modalities being studied demonstrate significant promise for the future treatment of the expanding space of NMIBC.
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Affiliation(s)
- Shannon McNall
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (K.R.-C.); (M.C.)
| | - Kailey Hooper
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (K.H.); (T.S.)
| | - Travis Sullivan
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (K.H.); (T.S.)
| | - Kimberly Rieger-Christ
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (K.R.-C.); (M.C.)
- Department of Translational Research, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (K.H.); (T.S.)
| | - Matthew Clements
- Department of Urology, Lahey Hospital & Medical Center, Burlington, MA 01805, USA; (K.R.-C.); (M.C.)
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Leonardi R, Ambrosini F, Cafarelli A, Calarco A, Colombo R, Tuzzolo D, De Marco F, Ferrari G, Ludovico G, Pecoraro S, De Cobelli O, Terrone C, Mantica G. Office-based management of Non-Muscle Invasive Bladder Cancer (NMIBC): A position paper on current state of the art and future perspectives. Arch Ital Urol Androl 2024; 96:12404. [PMID: 38502027 DOI: 10.4081/aiua.2024.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 03/20/2024] Open
Abstract
To the Editor, Bladder cancer is one of the most common cancers in humans, representing the 7th and 17th type of neoplasm in both genders. Its incidence and mortality are quite heterogeneous in different countries and are due to different risk factors, quality and prevalence of healthcare and the possibility of early diagnosis and treatment of the tumor and its potential recurrences [...].
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Affiliation(s)
- Rosario Leonardi
- Casa di Cura Musumeci GECAS, Gravina di Catania; Urologi Ospedalità Gestione Privata (UrOP).
| | | | - Angelo Cafarelli
- Urology Unit, Villa Igea, Ancona; Urologi Ospedalità Gestione Privata (UrOP).
| | | | - Renzo Colombo
- Department of Urology, Vita e Salute San Raffaele University, Milan; Urologi Ospedalità Gestione Privata (UrOP).
| | | | | | - Giovanni Ferrari
- Hesperia Hospital, Modena; Urologi Ospedalità Gestione Privata (UrOP).
| | - Giuseppe Ludovico
- Ospedale Miulli, Acquaviva delle Fonti, Bari; Urologi Ospedalità Gestione Privata (UrOP).
| | | | - Ottavio De Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan; Urologi Ospedalità Gestione Privata (UrOP).
| | - Carlo Terrone
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova.
| | - Guglielmo Mantica
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova.
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Laurie MA, Zhou SR, Islam MT, Shkolyar E, Xing L, Liao JC. Bladder Cancer and Artificial Intelligence: Emerging Applications. Urol Clin North Am 2024; 51:63-75. [PMID: 37945103 PMCID: PMC10697017 DOI: 10.1016/j.ucl.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Bladder cancer is a common and heterogeneous disease that poses a significant burden to the patient and health care system. Major unmet needs include effective early detection strategy, imprecision of risk stratification, and treatment-associated morbidities. The existing clinical paradigm is imprecise, which results in missed tumors, suboptimal therapy, and disease progression. Artificial intelligence holds immense potential to address many unmet needs in bladder cancer, including early detection, risk stratification, treatment planning, quality assessment, and outcome prediction. Despite recent advances, extensive work remains to affirm the efficacy of artificial intelligence as a decision-making tool for bladder cancer management.
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Affiliation(s)
- Mark A Laurie
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5656, Palo Alto, CA 94304, USA; Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive Room G204, Stanford, CA 94305-5847, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; Institute for Computational and Mathematical Engineering, Stanford University School of Engineering, Stanford, CA 94305, USA
| | - Steve R Zhou
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5656, Palo Alto, CA 94304, USA
| | - Md Tauhidul Islam
- Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive Room G204, Stanford, CA 94305-5847, USA
| | - Eugene Shkolyar
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5656, Palo Alto, CA 94304, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Lei Xing
- Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive Room G204, Stanford, CA 94305-5847, USA
| | - Joseph C Liao
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5656, Palo Alto, CA 94304, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA.
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4
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Köhler CU, Schork K, Turewicz M, Eisenacher M, Roghmann F, Noldus J, Marcus K, Brüning T, Käfferlein HU. Use of Multiple Machine Learning Approaches for Selecting Urothelial Cancer-Specific DNA Methylation Biomarkers in Urine. Int J Mol Sci 2024; 25:738. [PMID: 38255812 PMCID: PMC10815677 DOI: 10.3390/ijms25020738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Diagnosing urothelial cancer (UCa) via invasive cystoscopy is painful, specifically in men, and can cause infection and bleeding. Because the UCa risk is higher for male patients, urinary non-invasive UCa biomarkers are highly desired to stratify men for invasive cystoscopy. We previously identified multiple DNA methylation sites in urine samples that detect UCa with a high sensitivity and specificity in men. Here, we identified the most relevant markers by employing multiple statistical approaches and machine learning (random forest, boosted trees, LASSO) using a dataset of 251 male UCa patients and 111 controls. Three CpG sites located in ALOX5, TRPS1 and an intergenic region on chromosome 16 have been concordantly selected by all approaches, and their combination in a single decision matrix for clinical use was tested based on their respective thresholds of the individual CpGs. The combination of ALOX5 and TRPS1 yielded the best overall sensitivity (61%) at a pre-set specificity of 95%. This combination exceeded both the diagnostic performance of the most sensitive bioinformatic approach and that of the best single CpG. In summary, we showed that overlap analysis of multiple statistical approaches identifies the most reliable biomarkers for UCa in a male collective. The results may assist in stratifying men for cystoscopy.
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Affiliation(s)
- Christina U. Köhler
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany; (C.U.K.)
| | - Karin Schork
- Medizinisches Proteom-Center, Medical Faculty, Ruhr-University Bochum and Medical Proteome Analysis, Center for Protein Diagnostics (PRODI), Gesundheitscampus 4, 44081 Bochum, Germany
| | - Michael Turewicz
- Medizinisches Proteom-Center, Medical Faculty, Ruhr-University Bochum and Medical Proteome Analysis, Center for Protein Diagnostics (PRODI), Gesundheitscampus 4, 44081 Bochum, Germany
| | - Martin Eisenacher
- Medizinisches Proteom-Center, Medical Faculty, Ruhr-University Bochum and Medical Proteome Analysis, Center for Protein Diagnostics (PRODI), Gesundheitscampus 4, 44081 Bochum, Germany
| | - Florian Roghmann
- Department of Urology, Marien Hospital Herne, University Hospital of the Ruhr University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Joachim Noldus
- Department of Urology, Marien Hospital Herne, University Hospital of the Ruhr University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Katrin Marcus
- Medizinisches Proteom-Center, Medical Faculty, Ruhr-University Bochum and Medical Proteome Analysis, Center for Protein Diagnostics (PRODI), Gesundheitscampus 4, 44081 Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany; (C.U.K.)
| | - Heiko U. Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany; (C.U.K.)
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Furuya H, Sakatani T, Tanaka S, Murakami K, Waldron RT, Hogrefe W, Rosser CJ. Bladder cancer risk stratification with the Oncuria 10-plex bead-based urinalysis assay using three different Luminex xMAP instrumentation platforms. J Transl Med 2024; 22:8. [PMID: 38167321 PMCID: PMC10763405 DOI: 10.1186/s12967-023-04811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND No single marker of bladder cancer (BC) exists in urine samples with sufficient accuracy for disease diagnosis and treatment monitoring. The multiplex Oncuria BC assay noninvasively quantifies the concentration of 10 protein analytes in voided urine samples to quickly generate a unique molecular profile with proven BC diagnostic and treatment-tracking utility. Test adoption by diagnostic and research laboratories mandates reliably reproducible assay performance across a variety of instrumentation platforms used in different laboratories. METHODS We compared the performance of the clinically validated Oncuria BC multiplex immunoassay when data output was generated on three different analyzer systems. Voided urine samples from 36 subjects (18 with BC and 18 Controls) were reacted with Oncuria test reagents in three 96-well microtiter plates on Day 1, and consecutively evaluated on the LED/image-based MagPix, and laser/flow-based Luminex 200 and FlexMap 3D (all xMAP instruments from Luminex Corp., Austin, TX) on Day 2. The BC assay uses magnetic bead-based fluorescence technology (xMAP, Multi-analyte profiling; Luminex) to simultaneously quantify 10 protein analytes in urine specimens [i.e., angiogenin (ANG), apolipoprotein E (ApoE), carbonic anhydrase IX (CA9), CXCL8/interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-10 (MMP-10), serpin A1/alpha-1 anti-trypsin (A1AT), serpin E1/plasminogen activator inhibitor-1 (PAI-1), CD138/syndecan-1 (SDC1), and vascular endothelial growth factor-A (VEGF-A)]. All three analyzers quantify fluorescence signals generated by the Oncuria assay. RESULTS All three platforms categorized all 10 analytes in identical samples at nearly identical concentrations, with variance across systems typically < 5%. While the most contemporary instrument, the FlexMap 3D, output higher raw fluorescence values than the two comparator systems, standard curve slopes and analyte concentrations determined in urine samples were concordant across all three units. Forty-four percent of BC samples registered ≥ 1 analyte above the highest standard concentration, i.e., A1AT (n = 7/18), IL-8 (n = 5), and/or ANG (n = 2), while only one control sample registered an analyte (A1AT) above the highest standard concentration. CONCLUSION Multiplex BC assays generate detailed molecular signatures useful for identifying BC, predicting treatment responsiveness, and tracking disease progression and recurrence. The similar performance of the Oncuria assay across three different analyzer systems supports test adaptation by clinical and research laboratories using existing xMAP platforms. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov as NCT04564781, NCT03193528, NCT03193541, and NCT03193515.
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Affiliation(s)
- Hideki Furuya
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA.
- Department of Biomedical Sciences, Cedars‑Sinai Medical Center, Los Angeles, CA, USA.
| | - Toru Sakatani
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
- Department of Urology, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
| | - Sunao Tanaka
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
| | - Kaoru Murakami
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
- Department of Urology, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
| | - Richard T Waldron
- Department of Medicine, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
| | | | - Charles J Rosser
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
- Department of Urology, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
- Nonagen Bioscience Corp., Los Angeles, CA, USA
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6
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Furuya H, Sakatani T, Tanaka S, Murakami K, Waldron RT, Hogrefe W, Rosser CJ. Bladder cancer risk stratification with the Oncuria 10-plex bead-based urinalysis assay using three different Luminex xMAP instrumentation platforms. RESEARCH SQUARE 2023:rs.3.rs-3635581. [PMID: 38045238 PMCID: PMC10690323 DOI: 10.21203/rs.3.rs-3635581/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background No single marker of bladder cancer (BC) exists in urine samples with sufficient accuracy for disease diagnosis and treatment monitoring. The multiplex Oncuria BC assay noninvasively quantifies the concentration of 10 protein analytes in voided urine samples to quickly generate a unique molecular profile with proven BC diagnostic and treatment-tracking utility. Test adoption by diagnostic and research laboratories mandates reliably reproducible assay performance across a variety of instrumentation platforms used in different laboratories. Methods We compared the performance of the clinically validated Oncuria BC multiplex immunoassay when data output was generated on three different analyzer systems. Voided urine samples from 36 subjects (18 with BC and 18 Controls) were reacted with Oncuria test reagents in three 96-well microtiter plates on Day 1, and consecutively evaluated on the LED/image-based MagPix, and laser/flow based Luminex 200 and FlexMap 3D (all xMAP instruments from Luminex Corp., Austin, TX) on Day 2. The BC assay uses magnetic bead-based fluorescence technology (xMAP, Multi-analyte profiling; Luminex) to simultaneously quantify 10 protein analytes in urine specimens [i.e., angiogenin (ANG), apolipoprotein E (ApoE), carbonic anhydrase IX (CA9), CXCL8/interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-10 (MMP-10), serpin A1/alpha-1 anti-trypsin (A1AT), serpin E1/plasminogen activator inhibitor-1 (PAI-1), CD138/syndecan-1 (SDC1), and vascular endothelial growth factor-A (VEGF-A)]. Results All three platforms categorized all 10 analytes in identical samples at nearly identical concentrations, with variance across systems typically <5%. While the most contemporary instrument, the FlexMap 3D, output higher raw fluorescence values than the two comparator systems, standard curve slopes and analyte concentrations determined in urine samples were concordant across all three units. Forty-four percent of BC samples registered ≥1 analyte above the highest standard concentration, i.e., A1AT (n=7/18), IL-8 (n=5), and/or ANG (n=2). In Controls, A1AT was higher in one sample. Conclusion Multiplex BC assays generate detailed molecular signatures useful for identifying BC, predicting treatment esponsiveness, and tracking disease progression and recurrence. The similar performance of the Oncuria assay across three different analyzer systems supports test adaptation by clinical and research laboratories using existing xMAP platforms. Trial Registration This study was registered at ClinicalTrials.gov as NCT04564781, NCT03193528, NCT03193541, and NCT03193515.
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Affiliation(s)
| | - Toru Sakatani
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | - Sunao Tanaka
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | - Kaoru Murakami
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | | | | | - Charles J Rosser
- Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
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Tang NT, Robinson R, Snook RD, Brown M, Clarke N, Gardner P. Classification of formalin-fixed bladder cancer cells with laser tweezer Raman spectroscopy. Analyst 2023; 148:4099-4108. [PMID: 37486734 DOI: 10.1039/d3an00119a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Bladder cancer is a common cancer that is relatively hard to detect at an early stage because of its non-obvious symptoms. It is known that bladder cells can be found in urine samples which potentially could be used for early detection of bladder cancer. Raman spectroscopy is a powerful non-invasive tool for accessing biochemical information of cells. Combined with laser tweezers, to allow isolation of single cells, Raman spectroscopy has been used to characterise a number of bladder cells that might be found in a urine sample. Using principal component-canonical variates analysis (PC-CVA) and k-fold validation, the results shows that the invasive bladder cancer cells can be identified with accuracy greater than 87%. This demonstrates the potential of developing an early detection method that identifies the invasive bladder cancer cells in urine samples.
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Affiliation(s)
- Nga Tsing Tang
- Department of Chemical Engineering and Analytical Science, School of Engineering, University of Manchester, Manchester, M13 9PL, UK.
- Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN, UK
| | - Richard Robinson
- Division of Cancer Sciences, University of Manchester, Manchester, M20 4GJ, UK
- Department of Urology, Salford Royal NHS Foundation Trust, Salford, M6 8HD, UK
| | - Richard D Snook
- Department of Chemical Engineering and Analytical Science, School of Engineering, University of Manchester, Manchester, M13 9PL, UK.
- Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN, UK
| | - Mick Brown
- Division of Cancer Sciences, University of Manchester, Manchester, M20 4GJ, UK
| | - Noel Clarke
- Division of Cancer Sciences, University of Manchester, Manchester, M20 4GJ, UK
- Department of Urology, Salford Royal NHS Foundation Trust, Salford, M6 8HD, UK
- Department of Surgery, The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Peter Gardner
- Department of Chemical Engineering and Analytical Science, School of Engineering, University of Manchester, Manchester, M13 9PL, UK.
- Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN, UK
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Rasti A, Khalili M, Fakhr Yasseri AM, Nasirian N, Shirkoohi R, Nowroozi MR, Modarressi MH. Evaluation of IGF2, KRT14, and KRT20 as Urinary Biomarkers in Patients with Bladder Cancer. Rep Biochem Mol Biol 2023; 11:710-719. [PMID: 37131897 PMCID: PMC10149136 DOI: 10.52547/rbmb.11.4.710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/24/2022] [Indexed: 05/04/2023]
Abstract
Background Many researchers have tried to identify bladder cancer biomarkers to reduce the need for cystoscopy. The aim of this study was to identify and measure appropriate transcripts in patient urine to develop a non-invasive screening test. Methods From February 2020 to May 2022, 49 samples were obtained from Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran. Twenty-two samples were obtained from bladder cancer patients and 27 from bladder cancer-free subjects. RNA was extracted from participant samples, quantitative RT-PCR was performed, and TNP plots were used to assess IGF2 (NCBI Gene ID: 3481), KRT14 (NCBI Gene ID: 3861) and KRT20 (NCBI Gene ID: 54474) expression. For UCSC Xena analysis, Dataset ID: TCGA-BLCA was used to compare transitional cell carcinoma (TCC) and normal samples for survival rates. Results IGF and KRT14 were more greatly expressed in patient urine samples than in those of the normal group. However, KRT20 expression did not significantly differ between the two groups. IGF2 had 45.45 and 88.89% sensitivity and specificity, respectively, for detecting TCC in urine samples while KRT14 had 59 and 88.89% sensitivity and specificity, respectively. Also, these results infer that overexpression of IGF would be prognosticators of poor TCC outcomes. Conclusion Our study showed that IGF2 and KRT14 are overexpressed in bladder cancer patient urine, and IGF2 could be a potential biomarker for poor prognoses in TCC.
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Affiliation(s)
- Azam Rasti
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Masoud Khalili
- Department of Urology, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
| | | | - Neda Nasirian
- Department of Pathobiology, School of Medicine, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Reza Shirkoohi
- Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Mohammad Hossein Modarressi
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Corresponding author: Mohammad Hossein Modarressi; Tel: +98 9123385292; E-mail:
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